[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-107-2-medical-surgical-051":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":34,"lastmod":63},"內外科護理學","medical-surgical",{"id":7,"webId":8,"year":9,"session":10,"subject":4,"number":11,"stem":12,"options":13,"answer":18,"answerNote":19,"images":20,"explanation":21,"explanationDeep":22,"topics":23,"freq":25},"nurse-107-2-內外科護理學-051","nurse-107-2-medical-surgical-051",107,2,51,"一位 23 歲女性主訴最近食慾不振、疲倦、發燒及體重減輕，經身體評估發現口腔潰瘍、左右膝關節有壓痛、腫脹，另抗核性抗體（ANA）呈現陽性，下列何者為其最可能之診斷？",{"A":14,"B":15,"C":16,"D":17},"類風濕性關節炎","全身性紅斑性狼瘡","骨性關節炎","後天免疫缺乏症候群","B",null,[],"本題考點在辨識全身性紅斑性狼瘡(SLE)的多系統自體免疫表現。依 SLE 分類準則,育齡女性出現口腔潰瘍、多發性關節炎、發燒、體重減輕等全身症狀,加上抗核抗體(ANA)陽性,即高度指向 SLE,故選 B;ANA 是 SLE 最敏感的篩檢指標。選項 A 類風濕性關節炎以對稱性小關節侵犯與晨僵為主,診斷靠 RF、anti-CCP;選項 C 骨性關節炎屬退化性、好發於負重大關節,無全身炎症與 ANA 陽性;選項 D 後天免疫缺乏症候群以免疫低下併機會性感染表現,不符此自體免疫圖像。","SLE 屬第三型過敏(免疫複合體沉積)的自體免疫病,好發育齡女性。ACR 十一項準則可用口訣『SOAP BRAIN MD』:漿膜炎、口腔潰瘍、關節炎、光敏感、血液異常、腎病變、ANA、免疫學(抗 dsDNA\u002F抗 Sm)、神經症狀、頰部蝴蝶斑、盤狀紅斑,符合四項即可診斷。ANA 敏感度高但特異度低;抗 dsDNA 與抗 Sm 才具高特異度,且抗 dsDNA 效價常與狼瘡腎炎活性平行。",[24,26,29,31],{"term":15,"count":25},12,{"term":27,"count":28},"抗核抗體 ANA",3,{"term":30,"count":28},"自體免疫疾病",{"term":32,"count":33},"SLE 分類準則",1,[35,39,44,48,53,58],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-107-2-medical-surgical-052","有關免疫反應之身體屏障的敘述，下列何者錯誤？",52,{"webId":40,"stem":41,"number":42,"year":43,"session":33},"nurse-108-1-medical-surgical-068","有關糖尿病病人運動之護理指導，下列何者正確？",68,108,{"webId":45,"stem":46,"number":10,"year":47,"session":33},"nurse-109-1-medical-surgical-002","右側大腦損傷所引起的功能缺失，下列何者正確？①左側偏癱 ②空間及認知缺損 ③語言及計算能力降低 ④行動變得快及衝動",109,{"webId":49,"stem":50,"number":51,"year":52,"session":33},"nurse-110-1-medical-surgical-040","有關預防乳癌病人術後淋巴水腫的照護，下列敘述何者正確？",40,110,{"webId":54,"stem":55,"number":56,"year":57,"session":10},"nurse-111-2-medical-surgical-004","有關誘發腦下垂體中風原因的敘述，下列何者正確？",4,111,{"webId":59,"stem":60,"number":61,"year":62,"session":10},"nurse-112-2-medical-surgical-038","王小姐最喜歡吃速食，餐餐吃都不膩，最近出現口炎、吞嚥困難且指甲萎縮變薄呈湯匙狀，醫師告知為貧血，王小姐最有可能罹患那一種貧血？",38,112,"2026-09-04",1788510725358]